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A study published in the March issue of the American Journal of Nursing finds that during the last recession, newly-licensed registered nurses (RNs) perceived fewer job opportunities but reported higher commitment to their employers, a better work environment, fewer injuries, and worked fewer hours than newly-licensed RNs reported during better economic times.

The results were drawn from two surveys of new RNs in 15 states, one conducted in 2006 prior to the recession and the second conducted in 2009 during the recession. The two groups were demographically similar, but the second group reported a better health status and fewer needle stick injuries, sprains, and strains. The 2009 group also reported working an average of 52 hours less during a year, reported better nurse-physician relationships, and perceived the work environment as significantly better.

While nurse-to-patient ratios are widely recognized as an important factor in determining the quality of patient care, those ratios are not always easy to change without significant cost and investment of resources. What’s more, the projected nursing shortage will make it even more difficult for hospitals to increase nurse staffing.

A study published in the current issue of Health Care Management Review indicates that there are other aspects of registered nurses’ (RNs) work environments that RNs perceive can also have a significant impact on the quality of care they deliver. In order of influence, those factors are physical work environment, workgroup cohesion, nurse-physician relations, procedural justice, and job satisfaction. Nurses’ ratings of patient care quality were also higher in hospitals with Magnet® recognition programs, and lower in work settings with greater organizational constraints such as lack of equipment and supplies.

The study is based on a survey of 1,226 RNs, and is part of RN Work Project, directed by Christine Kovner, professor at the NYU College of Nursing, and Carol Brewer, professor at the School of Nursing, University at Buffalo.

“What we found in our study is that hospital administrators can improve a variety of work environment factors that are also likely to improve the quality of patient care, without having to change nurse-to-patient ratios,” says Maja Djukic, assistant professor at the NYU College of Nursing.

New Registered Nurses’ Lack of Geographic Mobility Has Negative Implications for Rural Health

A study on the geographic mobility of registered nurses (RNs) recently published in the December Health Affairs magazine suggests that the profession’s relative lack of mobility has serious implications for access to health care for people in rural areas.

According to the study, more than half (52.5 percent) of newly licensed RNs work within 40 miles of where they attended high school. Even more nurses reported working in the same state in which they attended high school. Nearly four in five (78.7 percent) of the nurses surveyed who held associate’s degrees and more than three in four (76.8 percent) of those with bachelor’s degrees practiced in the state they had attended high school.

According to the study’s authors, this lack of geographic mobility means that hospitals and other health care settings must rely heavily on locally-trained RNs and find it difficult to recruit nurses when there are not enough in the local area. This may be a particular problem in rural areas where there are fewer schools of nursing.

Lead investigators for the study were Christine Kovner, professor at the College of Nursing, New York University; Carol Brewer, professor at the School of Nursing, University at Buffalo; and Sean Corcoran, associate professor of educational economics at New York University. Kovner and Brewer direct the RN Work Project.

Caps on Overtime for Nurses are Effective, Researchers Conclude

A newly published study finds that state-mandated caps on nurses’ mandatory overtime hours are effective, reducing overtime hours for newly registered nurses in the affected states. Past research has demonstrated that fatigue caused by long hours without sufficient rest between shifts can lead to mistakes that imperil both patients and nurses.

This new study is part of the RN Work Project that is designed to learn more about nurses’ career patterns, including turnover. The overtime study draws on data from nurses in 34 states, covering 51 metropolitan areas and nine rural areas. It is published in the online edition of Nursing Outlook.

The RN Work Project study examines new nurses’ turnover rates, intentions, and attitudes. The study has revealed, among many things, that nearly one in five (18.1 percent) new nurses leave their first employer within a year of starting a job and more than one in four (26.2 percent) leave within two years.